基于患者健康行为互动模式的持续性护理服务在肥胖并高胰岛素血症患者中的干预作用

Discussion on intervention effect of continuous nursing service based on IMCHB model in obesity patients with hyperinsulinemia

目的:探讨基于患者健康行为互动模式(IMCHB)的持续性护理服务在肥胖并高胰岛素血症患者中的干预作用。方法:选取2018年1月—2020年1月收治的肥胖并高胰岛素血症患者96例,随机分为对照组与观察组,每组48例。对照组给予常规护理,观察组在常规护理基础上予以基于IMCHB模式的持续性护理服务。比较两组出院时、出院6个月的自我护理能力[采用自我护理能力测定量表(ESCA)]、体质量指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、餐后2 h胰岛素(2 h INS)、胰岛素抵抗指数(HOMA-IR)及血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平。结果:两组出院6个月的ESCA评分及血清HDL-C水平均高于出院时(P<0.05),且观察组高于对照组,差异有统计学意义(P<0.05);两组出院6个月的BMI,WHR及FPG,2 h PG,FINS,2 h INS,HOMA-IR,TC,TG,LDL-C水平均低于出院时,且观察组均低于对照组,差异有统计学意义(P<0.05)。结论:对肥胖并高胰岛素血症患者采取基于IMCHB模式的持续性护理服务,可提升患者自我护理能力,改善疾病控制效果。

Objective:To explore the intervention effect of continuous nursing service based on Cox interaction modelclient health behavior(IMCHB)in obesity patients with hyperinsulinemia.Methods:All 96 cases of obesity patients with hyperinsulinemia admitted in our hospital from January 2018 to January 2020 were selected,who were randomly divided intocontrol group and observation group,with 48 cases in each group.The control group was given routine nursing care,while the observation group was given continuous nursing service based on IMCHB model on the basis of routine nursing.The self-care ability(exercise of self-care agency,ESCA),body mass index(BMI),waist hip ratio(WHR),fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PG),fasting insulin(FINS)and postprandial 2-hour insulin(2h INS),insulin resistance index(HOMA-IR)and the serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)at discharge and 6 months after discharge were compared.Results:The ESCA scores and serum HDL-C levelsof the two groups at 6 months after discharge were higher than those at discharge(P<0.05),which in the observation group at 6 months after discharge were higher than those in the control group(P<0.05).The BMI,WHR,FPG,2 h PG,FINS,2h INS,HOMA-IR,TC,TG and LDL-C levels of the two groups at 6 months after discharge were lower than those at discharge(P<0.05),which in the observation group at 6 months after dischargewere lower than those in the control group(P<0.05).Conclusion:The continuous nursing service based on IMCHB model can promote the self-care ability of obesity patients with hyperinsulinemia,and improve the effect of disease control.